Active NPI
Cristina Putnam
- Clinical Social Worker
- Layton, UT
National Provider Identifier
1699349720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12296736-3501
- Practice address
- 934 S Main St
Layton, UT 84041-7135 - Phone
- (801) 773-7060
- Fax
- (801) 336-1787
- NPI assigned
- May 13, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW17067 | FL | |
| Clinical Social Worker | 1041C0700X | 12296736-3501 | UT | Primary |
Addresses
Primary practice location
934 S Main St
Layton, UT 84041-7135
Mailing address
934 S Main St
Layton, UT 84041-7135
Phone (801) 773-7060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW17067 | FL | MD | Clinical Social Worker |
| 12296736-3501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1699349720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "934 S MAIN ST",
"city": "LAYTON",
"state": "UT",
"postal_code": "840417135",
"telephone_number": "801-773-7060",
"fax_number": "801-336-1787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "934 S MAIN ST",
"city": "LAYTON",
"state": "UT",
"postal_code": "840417135",
"telephone_number": "801-773-7060",
"fax_number": "801-336-1787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTNAM",
"first_name": "CRISTINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-13",
"last_updated": "2021-12-02",
"certification_date": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW17067",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "12296736-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.